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jueves, 23 de abril de 2020

IV Corticosteroids + ACLS

The addition of intravenous (IV) corticosteroids to the standard Advanced Cardiovascular Life Support (ACLS) algorithm in the resuscitation of adult patients experiencing non-traumatic cardiac arrest may improve the chances of achieving survival to hospital discharge. These findings are based on a small number of studies with diverse methodology, significant variability in patient population, and poor-quality data. The optimal patient population, corticosteroid agent, dose, timing and duration of administration remains unclear and requires further research. Despite limited data, the potential benefits of corticosteroid administration may outweigh the small risks, and physicians should use their clinical judgment when administering this therapy...

Important Key points:

Limited data on IV corticosteroids in cardiac arrest with few RCTs to date. Additional RCTs are needed to draw definitive treatment recommendations.

There is uncertainty around which steroid formulation is best and what dose provides optimal benefit.

The potential benefits of IV corticosteroids may exceed limited harms and warrant consideration in cardiac arrest. Specifically, consider IV corticosteroids early (within 6 minutes of arrival in the ED) and as an adjunct agent in cardiac arrest particularly in patients with COPD, asthma and non-shockable cardiac rhythms"